Reality comes a lot cheaper than prime-time fantasy TV: People running real-life emergency rooms could do plenty with the $13 million NBC will pay for a single episode of 'ER.'

January 17, 1998|By Stephanie Shapiro | Stephanie Shapiro,SUN STAFF

When NBC agreed this week to pay $13 million per episode of "ER," Dr. David Meyers, chief of emergency medicine at north Baltimore's Sinai Hospital, had to chuckle: Sinai's brand-new, state-of-the-art emergency department cost $16 million to build -- a mere $3 million more than its fictional counterpart's weekly fee.

With $13 million, "you could buy an ED," Meyers says. "It's an incredible amount of money."

For the typical citizen, Warner Bros.' astronomical asking price for the rights to air "ER" may be one more ho-hum statistic in a universe where Hollywood stars and sports figures collectively earn enough to pay off the national debt.

But health-care professionals can translate these enormous sums into beds, staff, equipment and uninsured patients. They are struck by the ironies that abound when pop culture imitates (and costs more than) real life.

Meyers likes "ER"; he believes it's an accurate depiction of trench medicine, and Sinai has bought ad time to plugs its new ER on the show. Yet, it is "certainly eye-opening to see what they'll pay for an episode of that show when many [emergency departments] are struggling to meet needs on budgets that are infinitely smaller than that."

He is confident that Sinai's new emergency department will FTC meet the needs of the 175 to 185 people who use it daily, often as a primary-care facility. ("The ER is the only place where there's no 'wallet biopsy,' " says Meyers. Federal law requires emergency rooms to provide for any patient who walks through the door regardless of ability to pay.)

Still, if he had $13 million to play with, he would expand the observation unit, where patients needing short-term care for, say, asthma, migraines or sickle-cell pain are treated. He would also expand the blood-test/X-ray service area, and enhance the urgent-care area for cardiac patients. Last on his wish list: a program that would teach accident and violence prevention.

For Dr. Robert E. Roby, chief of the department of emergency at Maryland General Hospital in Baltimore, "$13 million for a hospital our size is a pretty enormous amount." Maryland General's ER was renovated two years ago for $4 million.

"If we were talking about a fantasy, dream-world sort of thing," Roby says, he'd build a whole new structure.

He would also upgrade the ER's dictation, voice-mail and computer systems to make the department run more efficiently. "It would be nice to have a patient walk in and hit one button, confirm information and be ready to go," Roby says.

Over at Union Memorial Hospital in north Baltimore, Paul Drehoff, director of public relations, is not certain what the emergency department would do with an extra $13 million. A $3.7 million renovation added some new features at Union Memorial, including a new pediatric waiting area, a hand-trauma area and a "fast track" admitting program.

With $13 million, "We could have expanded to three floors," Drehoff says, but that would exceed patient demand.

For Dr. Laura Pimentel, chairman of the department of emergency medicine at Mercy Medical Center, the skyrocketing cost of practicing show-biz medicine is beside the point. In reality, bottomless pockets are not always required to bring an ER up to speed, she says. In the next six months, Mercy will spend $250,000 on computer software and hardware that will automate patient tracking, Pimentel says.

"You can effectively increase the size of the department by automating your processes and being smarter about the way you do things."